Individual
MRS. TARA E ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
675 E NICOLLET BLVD, SUITE #135, BURNSVILLE, MN 55337-6700
(952) 892-2650
(952) 892-2654
Mailing address
4705 17TH AVE S, MINNEAPOLIS, MN 55407-3613
(612) 920-0302
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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